Provider Demographics
NPI:1366221665
Name:LIZARDI, ORLANDO GABRIEL (LMSW)
Entity type:Individual
Prefix:
First Name:ORLANDO
Middle Name:GABRIEL
Last Name:LIZARDI
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6309 FANNIN DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-5658
Mailing Address - Country:US
Mailing Address - Phone:423-602-3524
Mailing Address - Fax:
Practice Address - Street 1:395 PITCHFORK TRL
Practice Address - Street 2:
Practice Address - City:WILLOW PARK
Practice Address - State:TX
Practice Address - Zip Code:76087-3260
Practice Address - Country:US
Practice Address - Phone:313-241-8081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
TX109362104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator